title: [Instrument navigation in ensonasal sinus surgery].
abstract: BACKGROUND
  It is to be expected that, microsurgical operations in ENT must be partially performed without direct vision, e. g. without the possibility of controlling the preparation progress. This study provides a clinical example of how instrument navigation may be used in a safe and reasonable manner to the benefit of treatment quality. It is assumed that a median frontal sinus drainage procedure may be performed by means of a tracked sinus drill using solely instrument navigation.
  
  
  METHODS
  The sinus drill was registered using an optoelectric navigation system. An optical registration device was attached to the drill. In the period from 1 December 2011 to 30 April 2012 (5 months) 24 patients underwent a median frontal sinus drainage. 12 of the surgeries were performed under the condition operation navigation. The other 12 surgeries were performed using solely instrument navigation.
  
  
  RESULTS
  When applying mode Instrument Navigation (IN), a significantly reduced incision-to-suture time was registered within both groups. Within the group Draf IIB, it was reduced to 68.5% (from 67.1 min to 46.0 min). Resection efficiency, i. e., the ratio between the width of the frontal sinus ostium and the required total surgery time, widely differed to the benefit of group IN. Within both groups, the questionnaire revealed a high level of confidence in Surgical Management and Guidance Systems (SMGS) functionalities (100%).
  
  
  CONCLUSIONS
  The present study was designed to show for the first time a median frontal sinus drainage under the condition solely instrument navigation.
authors.affiliation: ACQUA Clinic, Department of ENT, Leipzig.
authors.forename: G
authors.initials: G
authors.lastname: Strauss
authors.forename: S
authors.initials: S
authors.lastname: Schaller
authors.forename: I
authors.initials: I
authors.lastname: Gollnick
authors.forename: T C
authors.initials: TC
authors.lastname: Lueth
mesh_terms: D001291:Attitude of Health Personnel; D002908:Chronic Disease; D004322:Drainage / Q000295:instrumentation*; D004724:Endoscopy / Q000295:instrumentation*; D004867:Equipment Design; D005626:Frontal Sinus / Q000601:surgery; D015522:Frontal Sinusitis / Q000601:surgery*; D005858:Germany; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000295:instrumentation*; D021621:Imaging, Three-Dimensional / Q000295:instrumentation*; D008866:Microsurgery / Q000295:instrumentation*; D011183:Postoperative Complications / Q000209:etiology; D012008:Recurrence; D012086:Reoperation; D025321:Surgery, Computer-Assisted / Q000295:instrumentation*; D013525:Surgical Instruments; D013996:Time and Motion Studies; D014057:Tomography, X-Ray Computed / Q000295:instrumentation